Medical Benefit Credit & Refund Coordinator - Monroeville, PA (Hybrid)

CVS Health•Wexford, PA

7d•$17 - $28•Hybrid

About The Position

CVS Health Specialty Pharmacy is hiring a full-time Medical Benefit Credit and Refund Specialist Coordinator to handle insurance credit balance follow-up. The role ensures timely and accurate credit balance resolution with third-party payers while providing excellent customer service to patients, healthcare professionals, and insurance carriers. The position is based at the Monroeville, Pennsylvania facility and is part of a fast-paced, team-focused environment. The role offers free parking and a collaborative team environment with tools and resources to support success.

Requirements

At least 1 year of healthcare insurance-related experience.
Experience using Microsoft Office products, specifically Excel, Outlook, and Word.
Ability to commute to the Monroeville, Pennsylvania office.
Verifiable high school diploma or GED.

Nice To Haves

Medical insurance billing or collections experience.
Customer service experience in a healthcare environment.
Experience working in a healthcare reimbursement system.
Effective customer service skills and experience demonstrating the ability to work in a team environment.
Attention to detail.
Ability to use analytical skills.
Ability to manage multiple tasks simultaneously, prioritize by importance, and maintain strong attention to detail.
Ability to communicate professionally with clientele, both verbally and in writing.

Responsibilities

Conduct third-party insurance follow-up related to prescription medication dispensing by telephone, internet, and in writing.
Review and validate credit balances by verifying accurate billing and cash posting procedures.
Resolve credit balance issues, including identifying overpayments and validating appropriate revenue recognition.
Perform analytical activities for the revenue cycle department and manage healthcare accounts receivable.
Initiate refunds, reverse claims, request payer offsets, and post adjustment transactions.
Maintain chronological supporting notes detailing actions taken to resolve outstanding account balances.
Maintain patient demographic information and data collection systems.
Research and respond to insurance companies and governmental payers about collection issues and problems by telephone, internet, and in writing.
Contact patients, physician offices, and insurance companies as needed to validate claims processing and payments.